Dr. Meier on Ask the Doctor

KTVN Ask the Doctor 04.23.2018

What Is Septoplasty?

Like many surgical procedures, septoplasty may sound like a foreign and complicated procedure. However, it addresses a rather ordinary issue — nasal obstruction. If nasal obstruction has been a debilitating issue for you, septoplasty may be the right solution. If you experience nasal obstruction or are considering a septoplasty, here is what you need to know.

Nasal obstruction can occur for a variety of reasons. When the cause is the nasal septum, your doctor may suggest a septoplasty to correct it. The nasal septum is made up of both cartilage and bone, and divides the nose into left and right sides. It is covered with a thin membrane known as the mucosa, which functions like a layer of skin — it protects the cartilage and bone, and keeps the inside of the nose moist. If you have a deviated septum, this simply means that your septum is crooked. However, a deviated septum can easily obstruct airflow, blocking one or both nasal passages.

To determine the cause of nasal obstruction, your doctor will sometimes perform a nasal endoscopy. An endoscope is a thin, flexible device equipped with a tiny camera and a light. In this case, it is inserted into the nose, projecting a magnified image onto a screen. An endoscopy is often enough to diagnose the problem. A CT scan can also be used, but is not usually necessary.

If your doctor determines that a deviated septum is the cause of your nasal obstruction, then septoplasty can correct the deviation and improve airflow. This is the most common reason for septoplasty. A septoplasty can also be part of a larger operation, such as sinus surgery or nasal tumor removal, but this is less likely.

Septoplasty is generally performed on an outpatient basis; this means you come in and go home on the same day. The surgery is done in an operating room, under general anesthesia, unless you and your doctor have determined that local anesthesia is a better option. During the surgery itself, your doctor will attempt to straighten the deviated, or crooked, cartilage and bone. This requires the mucosa, or the inner “skin,” to be lifted off that cartilage and bone so that it can be reshaped, or in some cases, removed. Once the septum is reshaped and/or parts are removed, the lining is laid back down, and the surgery is complete.

After surgery, you can expect splints or packing inside your nose, or possibly dissolvable stitches. There may also be some swelling and/or draining of fluid. During recovery, you may have nasal stuffiness, and your doctor might want you to use a saline spray or irrigation, but overall, the pain should be mild. Most symptoms clear up in the first week, and then you can look forward to breathing easy.

Sources: http://care.american-rhinologic.org/septoplasty_turbinates
http://care.american-rhinologic.org/nasal_endoscopy

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Congratulations to Dr. Van Duyne!

Nevada ENT was proud to sponsor “Outrunning 50” – the winner of the Senior Women Division of the Reno Tahoe Odyssey.

Congratulations to Dr. Van Duyne who participated.

 

Advances in Endoscopic Sinus Surgery

Rhinology is one of the newest medical specialties with many exciting technological advances occurring in recent years. Endoscopic sinus surgery began in the 1980s, and has progressed in leaps and bounds over the ensuing decades. Dr. Meier attends multiple courses annually to stay up to date on the newest technologies employed in the medical and surgical management of chronic sinusitis and diseases of the anterior skull base.

Dr. Meier uses a combination of old and new products to ensure proper healing after endoscopic sinus surgery. He uses a new product, Posisep X, which is a dissolvable dressing made from Chitosan, a naturally occurring molecule that has hemostatic and anti-inflammatory properties. Most of the Posisep will rinse out in the week after sinus surgery.

Another product Dr. Meier uses is the Propel stent in specific cases. This is a degradable steroid-eluting stent that stays in the ethmoid cavity for one month after surgery. By delivering mometasone, it can decrease inflammation after endoscopic sinus surgery.

Dr. Meier does not use splints or non-absorbable packing after endoscopic sinus surgery and septoplasty. This is because of the mucosal-preserving techniques he uses, which reduce bleeding, and speeds up healing and recovery. When packing is not used, there is minimal pain after nasal surgery.

Under Dr. Meier’s guidance, both Renown and St. Mary’s have upgraded their endoscopy camera and tower to the Karl Storz Image One system. Video examples of this technology can be seen at the Karl Storz website. This advanced, high-definition technology has enabled Dr. Meier to perform more complicated endoscopic sinus surgery involving the skull base, the frontal and sphenoid sinuses.

Josh Meier, M.D. F.A.R.S.